Within a comprehensive health insurance system, black and Hispanic children appear more likely than white children to have worse outcomes for their asthma, according to a new study.
Researchers analysed data from 822,900 children aged 2 through 17 years who were covered by the same health insurance programme. Asthma prevalence, treatment patterns and outcomes were assessed among children age 2 to 4, 5 to 10 and 11 to 17.
Racial and ethnic differences were apparent in several measures and age groups. Black and Hispanic children were more likely to be diagnosed with asthma at all ages. Black children of all ages and Hispanic children age 5 to 10 were more likely to have potentially avoidable hospitalisations or emergency department visits related to asthma.
“Black children, who at all ages were more likely to have a diagnosis of asthma and to have poorer outcomes than white children, were also more likely to receive recommended asthma medications, especially inhaled corticosteroids,” the study found. However, this could be related to the higher rates of emergency department visits and potentially avoidable hospitalisations among these children, as medications could have been prescribed and filled during or after these visits, the researchers noted.
They also found that black children were also less likely to receive care from a specialist, who may be more likely to treat asthma according to guidelines, including appropriate use of controller medications.
“Thus, even though black children filled more prescriptions for asthma medications, they may have been less likely than white children who visited specialists to control their asthma and use the medications appropriately,” the team reported.
In light of the study findings, the researchers concluded that eliminating racial and ethnic disparities in healthcare likely requires a “multifaceted approach beyond universal health insurance coverage.”
To appear in August issue of
Archives of Pediatrics and Adolescent Medicine
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